Catholic Health Services (CHS) hosted a heated public forum to allow the community to express their opinions and ask questions regarding the hospital’s recent announcement about closing the Labor and Delivery unit at St. Catherine (St. Cat’s) of Siena hospital by February 1.
A state-mandated public meeting, where the CEO and COO were present, occurred on Thursday, January 18, involving over ten executives and board members of CHS and St. Cat’s, and over 75 community members, hospital staff, and public officials.
The proposed closure sparked many conversations throughout the Smithtown community. Current and former maternity nurses have come forward to express their thoughts on the unit closing. Just an hour prior to Thursday’s meeting, members of New York State Nurses Association along with representatives from the office of Senator Monica Martinez (D-Brentwood) and Assemblyman Steve Stern (D-Dix Hills), members of the Long Island Federation of Labor, and Long Island Jobs for Justice announced their support for the Smithtown community, and their denouncement of the closure.
Questions for Catholic Health
Declan Doyle, the President of St. Cat’s hospital began the forum with a presentation on the current state of the hospital and why they are preparing to cease labor and delivery services. According to the presentation, the hospital will be ceasing care due to the current OB/GYN physicians and staff leaving under contractual changes.
“We do not employ our OB/GYN providers; our OB/GYN providers who work at St. Catherine are employed by Squarecare. Those physicians have decided to leave Squarecare and as a result of their contract and restrictions of that contract, the physicians will no longer be able to provide services at St. Catherine of Siena effective February 1 of this year, said Doyle. “The safety of our patients and our staff is the most essential thing for us. We will continue to provide the appropriate emergency services at the hospital for our patients. Our two hospitals in the county, Good Samaritan University Hospital and St. Charles are providing maternity services, and we will work with other local hospitals in the region including Stony Brook University Hospital and Huntington Hospital. We’ve been in contact with them in the last couple of weeks about the situation here at St. Catherine’s.”
Doyle went on to explain how the hospital is building and expanding other units, such as the emergency department, the chest pain unit, oncology, and neurosurgery. He mentioned these renovations are to start next month, just after the proposed closure date of the Labor and Delivery Unit.
Question: What happens to the staff of the unit on February 1?
Answer: “The staff of the unit, their employment status will not change. We are working under the guidance of the Department of Health, we are submitting closure plans, so the status of the staff of the unit will not change as of February 1.
Follow up question: What will they be doing?
Answer: “They will still remain employed at St. Catherine. We are working with the Department of Health, and we are under their guidance as to what action we can take. Until they receive it and they’ve approved the closure plan, we are not making any changes.”
Nurses of St. Catherine’s L&D unit continued to ask what they will be doing between the time the physicians leave on February 1, and the state approves the closure as well as how they will be supported and trained for other units. Doyle repeated that the status of the nurse’s employment will not change and that they will be continuing to work within the walls of St. Catherine.
Question: What has St. Catherine’s done to replace the doctors that are no longer serving the Maternity Unit?
Answer: “We have worked to recruit physicians, but we have not been successful in recruiting physicians.”
Follow Up Question: How long have you been working to recruit?
Answer: “We are continuously trying to recruit physicians and OB/GYNs. It was a continuous recruitment process.”
Follow up Question: One year? Two years? Three years? Give me a time frame.
Answer: “It’s ongoing, it’s continuous.”
Question: I’ve seen physicians leaving, and I’ve seen no physicians or replacements coming over the last 48 years. Why have they not been replaced?
Answer: “Physicians make choices on where they want to practice. There is a reduction in the number of OB/GYN physicians available, not just in this region, and those choosing to work on Long Island are fewer.”
Question: Were any of the physicians given an offer that was competitive? To stay, instead of going to St. Charles or Good Samaritan?
Answer: “We were working with the group that is leaving. They chose not to stay.”
Question: How do you plan on meeting the obstetric and gynecological emergencies of the surrounding community?
Answer: “For now, at St. Catherine we will have a coverage group covering emergencies. There will be OB/GYNs that we will be hiring to cover emergencies that if we have emergencies, they will show up. The goal is to stabilize the patient; if it is something that needs to be managed immediately, they will. If it’s something that can be transferred, that patient will be transferred to the hospital of choice or one of Catholic Health’s other facilities.”
Later in the forum, Catholic Health expanded their answer. “We will have the coverage group seven days a week, twenty-four hours a day, so if any emergencies arise, we will have a physician who can take care of those patients in the community. We will have on-call OB/GYN physicians available at all times,” answered Larry Eisenstein, Vice president of Catholic Health and Chief of Community and Public Health.
This coverage group actually consists of individual physicians who live in the area who are willing to cover calls at St. Catherine’s. All physicians live within thirty minutes of the hospital and are available 24/7, according to Eisenstein.
Question: What about routine gynecological care? How is this going to be affecting the area?
Answer: “We are trying to get practices to come to the area, I don’t know how long it is going to take to develop and grow but that is the goal. The immediate goal is to set up some type of a practice where we can handle routine OB/GYN care. It’s just a matter of those patients; for now, will not be able to actually deliver at St. Catherine.”
Question: There is a question of what will be done to the Kings Park Psychiatric Center. The community is always floating the idea of building low-income housing. What happens to the people who move into those neighborhoods if our hospital no longer provides any kind of maternity or women’s health?
Answer: “So, I think that’s a fair question for the community health leaders. That’s the sort of feedback that we’re looking forward to being part of the Health Equity Impact Assessment, but we have to respond from the data that we have today, and I can’t hypothetically say what we will do. But this is what I can say, Catholic Health is consistently looking at what’s best for the community and how we could be a positive contributor to the community. So, I can’t commit to what might happen and what populations of need may arise, but we will constantly be evaluating and looking to make things better. As you saw, the services are growing, many of them at St. Catherine’s based on the specific needs of the community.”
Senator Mario Mattera (R-St. James) interjected to ask Catholic Health about the projected time frame they have until when the plan will be submitted, when the State will get back to them, and when the public and staff will know the status of the unit.
Catholic Health responded with: “That will be established under [DOH] guidance. They will make a decision on the closure. We can’t close the unit until the Department of Health gives us the okay. We’re submitting and the physicians are not available to provide service at Saint Catherine’s at the end of this month.”
Senator Mattera then asked, “are we guaranteed all of our nurses, all our staff are guaranteed jobs? That’s the biggest thing, are they guaranteed jobs?
Answer: I guarantee we’ll work with the collective bargaining units to ensure that everybody has an opportunity, once we’ve received the Department of Health’s [response] and they allow us to do that.
Question: Is the closure of the unit reversible? If, in the future, physicians decide to come to St. Cat’s, can we reopen the unit?
Answer: “That goes back to my answer before, for which we’re constantly evaluating what’s best for the community. And to reopen a unit would be just like closing it, a state process of paperwork. So, I don’t know how long that would take. You can submit it and it might take a few days or it might take a few months, that’s out of our control. But to answer your question, there’s a legal process for opening the unit and a legal process for closing the unit. It’s prescribed in law by the state Department of Health. We’re following that so we can’t give an exact date because we don’t know what the state’s determination is going to ultimately be. What we can tell you is the providers who consistently bring the deliveries to St. Cat’s are not contractually allowed to work in St. Cat’s on February 1, and I realized that creates a confusing contradictory situation but that’s the situation.”
Question: How long did you know these doctors were leaving?
Answer: “We found out these doctors were leaving at the end of November.”
Question: What if the state says no?
Answer: “Then we will work with the state to understand what that means for us. They can say no, but that doesn’t change the situation that we do not have OB/GYNs to bring their deliveries to St Catherine’s.”
Dr. John Vullo, Vice President of the OB/GYN service line, joined the conversation to add some context to the closure.
“I was brought on, corporately, to come to St. Catherine’s and St. Charles to build the units. That was our plan originally. This was not the plan. We actually hired a minimally invasive surgeon who was starting in July to support the group that is now leaving. We were bringing in two oncologists on board to support the group that was there. We were not expecting this group to go to a different team, so to speak.”
Nurse Marion Ciecirski challenged Vullo’s statements. She explained that when she began her work in the unit, there were over twenty practitioners working. As they retired or left, they were not appropriately replaced, leaving the unit with one practice left today.
“Sir, you just said you can’t answer for the future. But that is what medicine is, isn’t it? We are supposed to be prepared,” said Ciecirski. “But you’re not going to be prepared for the migrant village that is going to open up down the block from St. Catherine’s in the old Kings Park Psych Center. And you weren’t prepared for the one group to be left. That’s not being prepared. And in medicine, you do need to be prepared. I can tell you our unit is always prepared, always set up for that emergency, always prepared for what may walk in the door, because that is a matter of life and death,” said Ciercirski.
“We’re very proud of the work that’s done in all of our Catholic Health hospitals,” said Eisenstein. “It’s one thing I’ve seen since the minute I got here. We are appreciative of all that you do, this is in no means meant to be something negative towards our staff. We think the work that’s been done is great. The market has changed, the providers aren’t there right now. We’re going to continuously look at what’s best for the community and respond to it. I’ve been here a year and a half, but it’s been clear to me that we’re trying to build every one of our campuses into something better and deliver better services but we’re very proud of the nurses in our workforce. You do a great job.”
Questions Regarding ‘Community Equity Impact Assessment’
Question: “Other than passing out surveys in today’s meeting, how are you assessing the health equity impact?”
With this question, Catholic Health passed the microphone to Ha Nguyen of the Sachs Policy Group, who has been hired from the State-recommended list of independent contractors to perform Community Equity Impact Assessments.
Answer: “The surveys that I have designed for you all include multiple questions to understand the impact of some of the things that were mentioned, transportation, migrants that may be coming in, workforce; it allows you to put that input in. The goal of this assessment survey is to help us understand ways to mitigate. If you are also interested in an interview, there is a way to share that in the community survey. You can add your name and phone number and let us know that you are interested in chatting with one of my team members, and we will do our best to capture all your concerns.”
Also handed out at the public forum was a QR code where the community can share its thoughts on the survey itself. If there is anything that the community believes the survey is missing or not focusing on enough, Nguyen asks to please let her know via the survey feedback form.
Community members spoke up with some concerns regarding the survey, including the fact that it needs to be available in multiple languages that are common within our community. It is now available in both Spanish and English.
The public forum came to an end earlier than planned as representatives of CHS, including Declan Doyle, Larry Eisenstein, and John Vullo, left the building at 7:00p.m. during the assessment discussion and did not return back to the meeting to answer the rest of the public’s questions. After some backlash from the community, a CHS representative did return to say that while the anonymous public survey was being discussed, CHS Representatives left the room for complete anonymity. More community questions were asked, however, they could not be answered without CHS’s presence.
As of press time, Catholic Health has not yet submitted their closure plan to the state, and they continue to assess the community’s needs throughout the process of making their submission. If you would like to participate in the Community Equity Impact Assessment survey to express your concerns, ask questions, and be a part of the assessment, please scan the QR code below.
